What To Expect

  Surgical Abortion
  Abortion by Pill (RU-486)

Surgical Abortion

Lab Work
A brief medical history will be taken and evaluated. A urine sample will be obtained and used to confirm a positive pregnancy test. Your vital signs will be taken, and a small amount of blood will be needed for hematocrit and Rh typing. If it is determined that you have Rh negative blood, RhoGAM will be administered immediately following the abortion procedure. This medication is necessary to prevent problems in future pregnancies.

Sizing Ultrasound
An ultrasound is performed on every patient to confirm intrauterine pregnancy and determine gestational age. This is essential to rule out ectopic pregnancy. An ultrasound can also give the physician vital information needed to best perform the procedure.

Counseling
The counseling session is intended to ensure all patients are aware of their options and are comfortable with their decision to terminate their pregnancy. It is also important that patients fully understand the procedure and how to take care of themselves afterward.

Medication and Anesthesia Options
Every patient will receive a local anesthetic to numb the cervix. Depending on your choice of sedation, Valium and Motrin may also be given to help you relax. Additional sedation options include Nitrous Oxide Gas, IV Sedation, or General Anesthesia.

	Nitrous Oxide Gas is a gas you breathe through your nose. This medication helps you to further relax and the effects last only while you are breathing the gas.
	IV Sedation is a combination of medications given intravenously. The combination of medications works as a strong sedation and sometimes has an amnesiac effect. With this sedation you may not remember the actual procedure.
	General Anesthesia is sedation that is also given intravenously. You are not awake during the procedure, and you will not feel or remember any part of the procedure.

If you choose to be sedated with IV Sedation or General Anesthesia, you must have someone to drive you from the facility after your procedure.

Procedure
The abortion procedure by D&E (Dilation and Evacuation) consists of the gradual dilation of the cervix and the use of vacuum aspiration to empty the contents of the uterus. Most procedures can be completed in one visit. If you are 18 weeks or greater, the procedure is done over a two day period. For these procedures, the physician will insert small dilators (laminaria) into the cervix on the first day. The laminaria will remain in place overnight to allow the cervix to slowly dilate. You will return to the office the following day where the laminaria will be removed and the procedure will then be completed. This is the safest and most comfortable process for terminating a pregnancy at this stage.

After the Abortion
The recovery period is an essential part of any surgical procedure. After the procedure, you will rest in our recovery room for a minimum of one hour. This time is to ensure your safety and well-being. Your vital signs will be monitored and you will be given juice and a snack for nourishment. We will also give you birth control pills if requested and ensure you understand your post-operative instructions. Prescriptions for pain medication and an antibiotic will be given. These prescriptions can be filled at our office for your convenience or at any pharmacy.

A member of our medical staff is on call 24 hours a day for questions or concerns.

Follow Up
You should return to our facility three weeks after your procedure for a follow-up exam. At this visit, we ensure that you have a negative pregnancy test and that your uterus has returned to its normal, non-pregnant size. If you would like to begin or continue birth control, you must have a current pap smear. If you are due for your annual exam, you may have your pap smear done at this visit.

Patient Instructions

	Dress comfortably
	Bring a maxi pad for your ride home
	Do not eat or drink 2 hours prior to your appointment (8 hours for General anesthesia patients)
	Bring someone to drive you home
	Please do not bring small children to the office

Abortion by Pill (RU-486)

After ultrasound, lab work, and counseling session are complete and your medical history is reviewed, you will receive your first dose of medication, Mifeprex. You will take this medication in our office. The second dose of medication, misoprostol, will be given for you to take two days later. You may be instructed to take this medication orally or to insert it vaginally. You will be given the option of taking this dose in the privacy of your own home, or you may return to the office if you prefer. Within 24 hours after taking misoprostol, you should experience cramping and bleeding. Your uterus will contract and its contents will be expelled.

Three weeks after your initial visit, you must return to A Jacksonville Women's Health Center for a pregnancy test and ultrasound examination to determine if the abortion is complete. If you are still pregnant, we will discuss your options, which may include a surgical procedure to end your pregnancy.

How Effective Is the Abortion by Pill?
Studies have shown that non-surgical abortion using Mifeprex and misoprostol is highly effective. Mifepristone has been successfully used by millions of women worldwide. In only 5 to 8 women out of every 100, this method will not completely terminate the pregnancy. For those women, a surgical abortion may be done at our facility at no additional charge.

Symptoms and Side Effects
Most women will experience cramping and bleeding, which usually means that the treatment is working. Bleeding may be similar to or heavier than your normal period. You may also pass some blood clots and tissue that come from the uterus. This is an expected part of the process. Bleeding lasts on average 9 to 16 days, but may last as long as 30 days. Side effects may include nausea, diarrhea, dizziness, and fatigue.